The prospects of Congress overriding the administration's efforts to nuke the HEAL program looked good this past summer when both the House and Senate Appropriations Committess voted to fund HEAL while the Health and Human Services' (HHS) FY 1992 appropriations bill was being considered in committee.
The hitch came with the end of the government's fiscal year on September 30, 1991: Congress, the cumbersome body that it is, had not taken action on the HEAL reauthorization bill or on HHS' FY 1992 appropriations bill. Without Congress passing a specific year-long appropriation for HEAL, no money was available to the program. Such fiscal quandaries are nothing new to Congress. When it comes to appropriating money and setting budgets, Congress moves forward with all the alacrity of a beached whale (with the exception of passing salary increases for its members).
When Congress can't make a decision, it opts for procrastination and routinely passes "continuing resolutions" that temporarily fund programs until they can be formally funded. Such was the case with HEAL. A continuing resolution was passed to fund HEAL for fiscal 1992 at the 1991 ceiling, $260 million.
The $260 million available for the HEAL program, while a victory of sorts in these fiscal tight-fisted times, fell short of the current loan demand. HHS began rationing most of these funds to students whose banks were willing to offer discounts. This put chiropractic students in a bind, because the banks weren't about to offer loan discounts with the high chiropractic loan default rates. The final blow came when HHS revealed the $260 million would only be available to current borrowers. HHS' proclamation was not without logic: with Congress failing to pass the HEAL reauthorization, HHS said they lacked the authority to make any new loans to borrowers.
It didn't look good: Congress probably would not resolve the HEAL reauthorization until the next session in 1992; while $260 million was available in loan money, it wouldn't benefit enough chiropractic students.
Congress reacted by passing a HHS appropriations bill that raised the $260 million to a ceiling of $290 million. The $30 million extra, it was thought, would fund new borrowers. Not so. HHS however reiterated its position that no new borrowers would get loans because Congress had failed to pass the HEAL reauthorization.
Just when the HEAL outlook was bleakest, congressional support by Senators Ted Kennedy (D-Mass.), Orrin Hatch (R-Utah), Arlen Specter (R-PA), Tom Harkin (D-Iowa), and Mark Hatfield (R-Oregon) were instrumental in passing S.2050, a bill requiring loan funds to be made available to new as well as current HEAL borrowers.
The HEAL battle continues, but thanks to the year-long lobbying efforts of the ACA, ICA, the Association of Chiropractic Colleges (ACC), and the Student American Chiropractic Association (SACA), the program continues to survive. Richard Miller, ACA's director of government relations, applauded chiropractic's team lobbying efforts, but cautioned: "The program is intact, but loan funds, while increased substantially because of our efforts, will still fall far short of meeting all of the anticipated demand in the program.
"This (HEAL) issue is still volatile in that most key members of Congress haven't yet personally dealt with the specifics of how an overhaul of the HEAL program would work. Accordingly, the precise mechanisms which would be employed to address high default rates have not yet been fully developed or agreed to. This issue will continue to require constant monitoring, and despite the positive developments so far, we cannot afford to become complacent or overconfident."
Steve Kelly
Assistant Editor